In medical terms, FTM Top Surgery is a subcutaneous mastectomy. The goal is more than just a flat chest; it should also have an aesthetically pleasing male contour, be fully sensate, and result in minimal scarring.
FTM Top Surgery includes:
- Removal of most of the breast tissue;
- Removal of excess skin;
- Removal of the inframammary fold.
- Reduction and repositioning of the nipple-areolar complex.
Keyhole Top Surgery
The Keyhole Top Surgery procedure is ideal for those who are small chested. During this procedure, a small incision is made along the bottom of the areola, and the breast tissue is removed with liposuction through this incision. With keyhole surgery, the nipple stalk is usually left intact, though some surgeons will resize the nipple itself. The areola is not resized. Nerve sensation is maintained.
Keyhole Top Surgery is typically an outpatient surgery that lasts 1.5-3 hours. General anesthesia is used, but patients are rarely catheterized.
Peri-Areolar Top Surgery
The Peri-Areolar Top Surgery procedure is ideal for those who are small chested, or those with B-sized chests and good skin elasticity. During this procedure, an incision is made all around the border of the areola. Additionally, a second, larger concentric circle incision is made and the resulting ring of skin removed. Breast tissue is removed and additional contouring with liposuction may be performed. A “drawstring” technique is used to bring the skin together and connect it to the edges of the areola, which may be downsized. With peri-areolar, the nipple stalk is usually left intact, though some surgeons will resize the nipple itself. Because the nipple stalk and nerve are not severed, sensation is often maintained.
Peri-Areolar Top Surgery is typically an outpatient surgery that lasts 3-5 hours. General anesthesia is used, but patients are rarely catheterized.
Double Incision Top Surgery
The Double Incision Top Surgery procedure is the most widely-used technique and is ideal for those who are medium to large chested. During this procedure, the skin on the chest is opened along two horizontal incisions, at the top and bottom of the pectoral muscle. (The muscle itself is not touched.) The skin is pulled back and the breast tissue is then removed.
Additional liposuction may be performed to provide a more masculine contour and/or help prevent Dog Ears. Depending on the surgeon, this liposuction is either done as part of the Top Surgery procedure and included in the cost, or performed as a separate “cosmetic” Male Chest Contouring procedure with added expense.
With Double Incision Top Surgery, there are various approaches that can be taken that result in different scar shapes: straight, curved, contoured, connected and more.
Free Nipple Grafts: Nipples are removed, re-sized and grafted on the chest. Patients have limited sensation through the nipple/areola complex.
Though less common, some surgeons will maintain the original nipple/areola complex instead of grafting, which usually preserves nerve sensation.
Double Incision Top Surgery is typically an outpatient surgery that lasts 3-4 hours. General anesthesia is used, but patients are rarely catheterized.
